DDAVP Spray (desmopressin acetate) is a synthetic analogue of vasopressin, specifically formulated as a nasal spray for the management of central diabetes insipidus and nocturnal enuresis. It acts on V2 receptors in the renal collecting ducts to promote water reabsorption, reducing urinary output and alleviating symptoms of polyuria and polydipsia. This intranasal delivery system ensures rapid absorption and predictable pharmacokinetics, offering a reliable therapeutic option for patients requiring long-term hormone replacement. Clinical use is supported by decades of evidence demonstrating its efficacy and safety profile in both adult and pediatric populations.

Features

• Contains desmopressin acetate 10 mcg per spray
• Available in 5 mL nasal spray bottle (approximately 50 doses)
• Synthetic vasopressin analogue with enhanced antidiuretic potency
• Intranasal administration for systemic absorption
• pH-balanced solution to minimize nasal irritation
• Preservative-free formulation
• Precise metered-dose delivery mechanism
• Room temperature storage stability

Benefits

• Effectively reduces excessive urine production in diabetes insipidus patients
• Provides predictable control of diuresis with single daily dosing in many cases
• Improves quality of life by eliminating frequent nighttime urination
• Enables normal daily activities without interruption for bathroom visits
• Reduces thirst and fluid intake to physiological levels
• Minimizes risk of dehydration and electrolyte imbalances

Common use

DDAVP Spray is primarily indicated for the treatment of central (cranial) diabetes insipidus, a condition characterized by deficiency of endogenous antidiuretic hormone (ADH). It is also used for managing primary nocturnal enuresis in children over 6 years of age who have normal renal function and no organic pathology. The medication may be prescribed off-label for certain bleeding disorders, including mild hemophilia A and von Willebrand’s disease type I, though intravenous formulations are typically preferred for hemostatic control.

Dosage and direction

For diabetes insipidus: Initiate with 10 mcg (one spray) daily, typically administered in the evening. Titrate based on response; most adults require 10-40 mcg daily divided into 1-2 doses. Pediatric dosing starts at 5 mcg daily, adjusted according to response. For nocturnal enuresis: Children aged 6+ years receive 20 mcg (two sprays) intranasally at bedtime. Administration technique: Insert nozzle into nostril while holding head upright, press firmly to release spray, and inhale gently during administration. Avoid deep inhalation that might draw medication into lungs. Prime the pump before first use by pressing several times until a fine mist appears.

Precautions

Monitor water intake and serum sodium levels regularly, especially during initiation and dose changes. Use caution in patients with conditions that may predispose to fluid overload, including renal impairment, heart failure, or hypertension. Avoid concomitant use with medications that increase ADH release or effect. Elderly patients require careful dose titration due to increased risk of hyponatremia. Nasal pathology (congestion, rhinitis, or mucosal atrophy) may impair absorption—consider alternative formulations if nasal administration is compromised.

Contraindications

Hypersensitivity to desmopressin acetate or any component of the formulation. Patients with moderate to severe renal impairment (creatinine clearance <50 mL/min). History of hyponatremia or current hyponatremia. Conditions associated with fluid and electrolyte imbalance. Patients with habitual or psychogenic polydipsia. Concurrent use with loop diuretics. Severe hepatic impairment where fluid regulation may be compromised.

Possible side effects

Common: Headache (10-15%), nausea (5-8%), mild nasal congestion or irritation (5-10%). Less common: Abdominal cramps, flushing, mild hypertension. Rare but serious: Hyponatremia and water intoxication (symptoms include headache, nausea, vomiting, weight gain, seizures, coma), severe allergic reactions including anaphylaxis, thrombotic events. Pediatric patients may experience emotional changes or sleep disturbances. Most side effects are dose-dependent and reversible with dose adjustment.

Drug interaction

NSAIDs may potentiate water retention and hyponatremia risk. Tricyclic antidepressants and SSRIs can enhance antidiuretic effect. Carbamazepine and chlorpromazine may potentiate ADH effect. Demeclocycline and lithium can antagonize antidiuretic effect. Glucocorticoids may affect fluid balance monitoring. Concomitant use with other pressor agents may increase hypertensive effects. Alcohol may interfere with drug efficacy and increase diuresis.

Missed dose

If a dose is missed, administer as soon as remembered unless it is nearly time for the next dose. Do not double the dose to make up for a missed administration. For diabetes insipidus patients, monitor urine output and thirst symptoms; temporary increased water intake may be necessary if dose is significantly delayed. For nocturnal enuresis, the dose should be taken at bedtime as scheduled—do not administer during nighttime if forgotten at bedtime.

Overdose

Symptoms include headache, nausea, vomiting, abdominal cramps, facial flushing, drowsiness, and weight gain due to water retention. Severe overdose may lead to hyponatremia, convulsions, coma, and cerebral edema. Treatment involves discontinuation of medication, fluid restriction, and symptomatic management. In severe cases with hyponatremia, careful administration of hypertonic saline may be necessary under hospital monitoring. Dialysis is not effective for drug removal due to protein binding.

Storage

Store at controlled room temperature (20-25°C/68-77°F). Do not freeze. Keep bottle tightly closed and protected from light. Discard 30 days after first use even if medication remains. Do not store in bathroom where moisture could affect stability. Keep out of reach of children and pets. Do not transfer to another container. Avoid exposure to extreme temperatures or direct sunlight.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Dosage and administration should be determined by a physician based on individual patient needs and response. The prescribing information provided here may not include all possible uses, directions, precautions, or interactions.

Reviews

Clinical studies demonstrate 85-90% efficacy in controlling diabetes insipidus symptoms with appropriate dosing. Patients report significant improvement in quality of life measures, particularly reduced nighttime awakenings and decreased thirst. Pediatric use for nocturnal enuresis shows 70-80% success rates in clinical trials. Some users note nasal irritation as a temporary concern that typically resolves with continued use. Medical professionals appreciate the predictable pharmacokinetics and established safety profile when monitored appropriately.